DorlandHealth

To explore recent and potential changes to the practice, we consulted with Garry Carneal, JD, MA, the president and CEO of Schooner Healthcare Services, LLC, to talk about the impact of social networking and wireless communication on case management. Garry is also co-chair of the steering committee at the Population Health Impact Institute.

Case In Point: How are advances in technology changing the landscape of case management and what technology specifically is leading the way?

Garry Carneal: According to several reputable resources, more than 2.5 billion text messages will be sent today in the United States. Texting has now become the most prolific form of mobile communication in the United States, overtaking cell phone calls. Howard Rosen, the founder and CEO of Life:WIRE, which is an interactive health management solution that uses text messaging and email, recently noted that “text messaging is taking off not only for younger Americans, but over half of all Americans who send and receive text messages today are 35 years and older.”

This is a unique development. And now dozens of text messaging platforms for health care are being offered in the market, running on everything from smart phones to basic cell phones, to improve communication channels, increase efficiencies and better engage individuals to achieve better health outcomes, according to Rosen.

Social and professional networking platforms also are spreading throughout the United States and globally faster than most ever anticipated just a few years ago. Case managers are getting into the act by signing up for a wide variety of social networking sites. For example, user groups for the Case Management Society of America have about 500 members on LinkedIn and about 250 members on Facebook. These types of social networking platforms (see the table on the next page) are allowing a greater level of professional and social networking on a wide array of issues impacting case managers—ranging from multistate licensure to specific clinical intervention strategies for targeted populations.

In addition, patients are becoming more comfortable connecting electronically with their providers to schedule appointments, reorder prescriptions, and track key health information.

Of course, many patients still don’t use computers and are not comfortable with these emerging communication options. However, with each passing year the percentage of the population that does not use the Internet or electronic media is shrinking.

CIP: How will social networking impact the practice of case management in the future?

GC: Case managers typically speak with their patients either through face-to-face encounters or via the telephone. It will be interesting to see how the practice of case management changes over the next three to five years with all of the emerging communication options. For example, can case managers leverage text messaging, encrypted emails, or social networking sites to better engage patients? The answer is likely yes in most practice settings.

With all of these new ways to communicate, case managers will need to be mindful of what types of communications are appropriate in the right circumstances. For example, some providers are giving relatives of patients undergoing surgery updates via Twitter through periodic “tweets” (we assume with the patient’s signed consent)—which of course highlights the potential danger of private health care information getting into the wrong hands.

Andrew J. Sigel, an attorney with Pepper Hamilton, points out that Facebook and other social networking sites allow users to regulate the security features on their individual pages. However, he admonishes a warning, saying that case managers and providers need to be careful about when and how they transmit protected health information (PHI) over these sites. He agrees that more research needs to be done in this area to fully assess both the opportunities and limitations.

CIP: How is the rise of social media going to impact the business side of case management?

GC: The emerging communication and social media platforms are redefining how to advertise. In fact, traditional marketing approaches are being rethought as the Internet and various online communities allow us to reach out to prospective customers in new and more targeted ways. President Obama’s election campaign serves as one illustrative example where he reached out to voters through a myriad of social networking and Internet sites with dramatic success.

The expansion of social media is creating new means for case managers to dynamically connect with their patients and other audiences. Moreover, this trend is creating opportunities to improve clinical and financial outcomes through inherently innovative and cost-effective ways.

Social Networking at a Glance

Facebook is a global social networking website that is operated and privately owned by Facebook Inc. Users can add friends, send messages, and update their personal profiles. Users can join networks organized by city, workplace, school and region.

Hi5 is a social networking website that in 2008 was the third most popular in terms of monthly unique visitors. Although created and headquartered in the United States, it is more popular abroad.

LinkedIn is a business-oriented social networking site founded in 2002 and mainly used for professional networking. As of July 2009, it had more than 43 million registered users, spanning 170 industries.

Twitter is a free social networking and micro-blogging service that enables its users to send and read messages known as tweets, or text-based posts limited to 140 characters. Senders can restrict delivery to those in their circle of friends or allow open access. Users can send and receive tweets via the Twitter website, short message service (SMS) or external applications.

A wiki is a website that is essentially a database for creating, browsing and searching through information. Wikis are often used to create collaborative websites, to power community websites, for personal notetaking, in corporate intranets, and in knowledge management systems. A wiki enables documents to be written collaboratively.